Covid-19 Screening

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Covid-19 Screening

St. Louis County Youth Sports Guidelines requires: Every coach, athlete and official MUST be screened on a daily basis before they enter the field, campus or facility where the sporting activity is designated to occur.
Please complete this form EACH DAY you work. This must be completed before you "report" to the site.

Today's Date *

JJJJ

Your First (F I R S T) Name *

Your Last (L A S T) Name *

Location/name of Park where you are working today *

Your Cell Phone Number *

Your Email Address *

I am fully vaccinated (2 weeks after your final shot) as of:

JJJJ

I have experienced one, any or all of the following new or worsening symptoms within the past 24 hours: *

Fever (temperature greater than 100.4 degrees Fahrenheit)

Cough

Shortness of breath or trouble breathing

Sore throat, different than your seasonal allergies

Loss of smell and/or taste

Abdominal pain

None of the above

Verplicht

If you checked any of the symptoms, YOU ARE NOT ELIGIBLE TO PARTICIPATE. Do not exit your vehicle and contact the UIC ASAP.

Have you had a close contact who has been diagnosed with COVID-19 in the past 2 weeks? *

Yes

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